Withdrawal symptoms of zopiclone: how to come off it safely

The withdrawal symptoms of zopiclone can include a few nights of worse sleep (rebound insomnia), anxiety, shakiness, irritability, sweating, headache, a racing heartbeat, aching muscles and confusion. They are most likely if you stop suddenly or cut your dose quickly. The safe way to come off zopiclone is a gradual reduction planned with your prescriber, at a pace that suits you.

This guide explains which withdrawal symptoms zopiclone can cause, why they happen, how long they can last and where to get support. Every fact comes from UK product information, the NHS, NICE or UK health bodies. It does not give a reduction schedule, because a safe plan has to be made for you by your prescriber. For the basics, see our complete guide to zopiclone.

Why zopiclone can cause withdrawal symptoms

When you take a sleeping tablet night after night, your brain adapts to it. The UK zopiclone Summary of Product Characteristics (SmPC) calls this physical dependence. It shows up as withdrawal symptoms after stopping suddenly or after a big drop in dose.

Dependence is more likely the longer you take zopiclone and the higher the dose. The SmPC says it can still happen with short-term use at normal doses. The risk is higher if you have ever had problems with alcohol or drugs, or have a mental health condition such as depression.

This is why zopiclone is meant for short courses. The NHS says it is usually not prescribed for more than 4 weeks. The SmPC adds that those 4 weeks include the time spent reducing the dose. Our zopiclone dose guide explains the UK strengths and course length.

Withdrawal symptoms of zopiclone

The official patient information leaflet (PIL) lists these withdrawal symptoms. Not everyone gets them, and most people only get some.

Type	Symptoms listed in the UK leaflet
Sleep	Rebound insomnia (sleep worse than before for a few nights), nightmares
Mood and mind	Feeling anxious, irritable or agitated, panic attacks, confusion, trouble focusing or concentrating
Body	Shakiness, sweating, headache, a fast or uneven heartbeat (palpitations), aching muscles, stomach problems
Senses	Being more sensitive to light, noise and touch, numbness or tingling in the hands and feet
Less common, more serious	Seeing or hearing things that are not there (hallucinations), a weaker grip on reality, lower awareness

Scotland’s national prescribing guide for benzodiazepines and Z-drugs warns that stopping suddenly can, rarely, cause confusion, psychosis or fits (convulsions). That is the main reason not to stop on your own.

Rebound insomnia or your old sleep problem?

Rebound insomnia is a short spell when your original sleep problem comes back in a stronger form. The leaflet says it can last “for a few nights” after stopping suddenly following long-term use. The SmPC says the risk is greater when stopping is abrupt.

Knowing this helps. A few bad nights after a dose change do not mean you cannot sleep without zopiclone. If poor sleep lasts for weeks, talk to your doctor about your underlying insomnia.

Zopiclone withdrawal timeline: how long does it last?

There is no fixed timeline, and no reliable source gives one for everyone. What UK guidance does say:

• When it can start: with shorter-acting medicines, symptoms may begin within a day of stopping, according to the Scottish guide.
• Rebound insomnia: usually a few nights, according to the leaflet.
• The whole reduction: the leaflet says coming off “may occur over a period of weeks to months”. The SmPC says tapering from a high dose may take longer than weeks or months.
• Longer-lasting symptoms: NICE guideline NG215 says symptoms can be delayed, can change over time, and can sometimes persist for a long period.

The Scottish guide, which covers benzodiazepines and Z-drugs together, says longer-lasting symptoms may affect up to 15% of people. It says insomnia from this cause gradually fades over 6 to 12 months. NICE also says it is not possible to predict who will be affected.

The UK Prescribed Medicines Review by Public Health England heard from patients whose withdrawal effects lasted many months. Many also felt they had not been warned about the risks. If your symptoms go on, say so. You should be taken seriously.

Coming off zopiclone safely

The NHS advice is clear: do not stop taking zopiclone suddenly. Your doctor will gradually reduce your dose so you can stop safely. NICE says a medicine like this should not be stopped abruptly except in exceptional medical circumstances.

A good plan, as described in NICE NG215 and the SmPC, usually looks like this:

1. A shared decision. You and your prescriber agree together when and how to reduce.
2. Small, slow steps. Reductions are proportionate to your current dose, so the steps get smaller as the dose gets lower.
3. A flexible pace. The plan is tailored to you. If withdrawal symptoms become hard to bear, the SmPC says your prescriber may pause the reduction or go back to the previous step.
4. Regular reviews. The Scottish guide recommends frequent check-ins during and after the reduction.
5. Another try if needed. If the first attempt does not work, you can try again later. NICE says the aim is to stop the dose rising and plan a new attempt.

Do not try to cope by taking another sleeping tablet or a sedative from elsewhere. NICE advises against treating withdrawal with another medicine that can cause dependence. Avoid alcohol too: the leaflet says it raises the risk of sleepwalking and similar behaviours on zopiclone.

How to wean off zopiclone 3.75 mg

3.75 mg is the lowest UK tablet strength. The leaflet says it is the usual starting dose for older people and people with kidney, liver or breathing problems. Even at this dose, you should not stop suddenly without advice.

We do not publish reduction steps for any strength. The right pace depends on how long you have taken zopiclone, your health and how you respond. Ask your prescriber or pharmacist how your tablets should be used during a reduction.

What is a zopiclone detox?

“Detox” usually means coming off a medicine under supervision. For most people, that is a gradual reduction managed by their GP, with support from their pharmacist. You do not need a private clinic to start.

Specialist help may suit you if you take higher doses than prescribed, use zopiclone with alcohol or other drugs, or have tried before without success. The NHS says a GP is a good place to start and can refer you to your local drug service. You can also contact that service yourself.

The leaflet lists signs that you may be dependent:

• you feel you need to keep taking it for longer than recommended
• you feel you need more than the recommended dose
• you use it for reasons other than prescribed
• you feel unwell when you stop and better when you take it again

If any of these sound familiar, tell your prescriber. NICE describes dependence as an expected effect of these medicines, so there is no need to feel ashamed to ask. Our guide to zopiclone dependence and addiction explains who is most at risk.

What the research shows

Large trials of zopiclone withdrawal are scarce. One older double-blind study, published in European Psychiatry in 1995, looked at people who had taken zopiclone 7.5 mg for at least 3 months. It compared a gradual withdrawal group with a group that carried on.

In the withdrawal group, 38% met the study’s definition of a withdrawal syndrome, compared with 20% of the control group. In most cases the symptoms reported were sleep complaints. This fits UK guidance that sleep problems are the most common thing to prepare for.

Many people are in the same position. The Prescribed Medicines Review found that 1.0 million adults in England (2%) had a Z-drug prescription dispensed in 2017 to 2018. About 100,000 had received one continuously from April 2015 to March 2018.

Supporting your sleep while you reduce

Looking after your sleep in other ways can help while you reduce. The NHS insomnia page says you may be offered cognitive behavioural therapy (CBT), face to face or through an online programme. Simple habits from the same page also help:

• only go to bed when you feel sleepy
• wind down for at least an hour before bed

Our insomnia guide covers causes and non-medicine treatments in more detail.

Legal status and your prescription

Zopiclone became a Class C drug under the Misuse of Drugs Act through the 2014 amendment order. It was added to Schedule 4 Part 1 of the Misuse of Drugs Regulations from 10 June 2014. It is legal to have it only when it has been prescribed for you. Our guide to controlled drugs in the UK explains what the classes and schedules mean.

The leaflet says Z-drugs should only be used by the person they are prescribed for. If you are unsure whether a pharmacy is genuine, see how to check a UK online pharmacy.

This article is for information only and does not replace advice from your doctor or pharmacist. Read our medical disclaimer.